I was asked at a meeting this afternoon what my "most frequent pieces of advice" were for clients. Here's a greatest hits list of encounters I've had in people's homes and what to do about it.

1. No bathroom or a half bath on the first floor- A half bath is a great idea for any house. The problem with them on the first floor is that they are usually either a design afterthought for new construction so they are tucked into a tight space, or they are in a location that makes it extremely difficult for them to expand if need be. No bathroom on the first level speaks for itself. The houses on the seacoast can range from new builds to 300+ years old so there is an incredible amount of variation.

2. Handrails, or lack thereof- Have two steps down into the living room? Have a split level but you took the railings down when you moved in because of the furniture? Don't like the idea of having a handrail on your front steps for esthetic reasons? Whatever the reason, these are prime areas to improve safety when looking to stay in your home. There are a number of products that have come on the market over the years that improve the outward appearance of some of these bars. This is also an important consideration if you are in the market for joint replacement (think knee, hip, shoulder) to prepare for that discharge. The other half of the equation is having them installed correctly. Have a professional put them in.

3. Laundry in the basement- When we moved in to our house a few years ago the washer and dryer was in the kitchen. An elderly couple had lived in the home two owners before and had brought the hook ups up from the basement. From a professional standpoint I dragged my feet moving them back to the basement knowing that they would move upstairs decades from now. At least we know where to put them. The #1 reason people cannot live on one level is having laundry in the basement. It's not the most pleasing to look at if there's no option to box them in, but it beats 12 stairs up and down with a laundry basket.

4. Delaying bringing services in- I think there's a misconception that once you have one person into your home it will inevitably and quickly turn into a tsunami of help that will result in you being swept out to assisted living or a skilled nursing facility. The truth of the matter is there are a number of opportunities along the way to bring services into your home that probably won't affect your ability to stay there. Some example services include:

- cleaning service- once a month, every other week, heavy cleaning, total house clean. You pick the level and adjust as need be over time.

- meal delivery- meals on wheels, take out on fridays, grocery delivery (where available), meal prep delivered. You pick the level of assistance. Maybe grocery shopping isn't your thing but you still have no problems cooking.

- money management- need help paying bills or staying on top of your checkbook? There are trained professionals to assist you with keeping your accounts in order. There is a checks and balances system in place to protect you as well

- respite- this is not an in home service typically. If you are the caregiver for an aging spouse there are respite programs in the area that will take over care for them to give you a "break" or the opportunity to not be responsible for them. I've seen this most commonly for individuals going into the hospital to have an elective procedure. Usually respite in a few weeks to a month, which gives the caregiver the chance to have surgery (joint replacements, etc), recovery, and return to caregiving when they are healthy and able.

5. Not having a plan in place- wanting to stay in your home is typically a polarizing decision. If you want to stay home, you need to have a plan in place. Mapping out your potential problems along the way as you age creates the opportunity for you to say "I want to stay until ..... happens" or "even if ..... happens, here's my plan to address it". The more clarity you have with these decisions and the more open you are with your family about them, the more likely they will be carried out.

The more clarity you have the greater chance your family will continue to work collaboratively to support your choices. Starting early, before you are confronted with the immediate need to make changes will save stress, time, money, and aggravation in the long run. Working with professionals trained to help individuals age in place will also ease the burden of these decisions.

If you are looking down the road and have questions about setting your home up for optimal accessibility and comfort to support aging- give me a call. I will help.